People who live with a spouse appear to be more likely to be healthy in terms of maintaining lower blood sugar levels , regardless of how harmonious or acrimonious their relationship is, suggests a study published online in the journal BMJ Open Diabetes. Research & Care .
Researchers believe that having a spouse or cohabiting partner may be an important relationship and a source of social support and/or stress for middle-aged and older adults on their health.
Previous studies have suggested that marriage and/or cohabitation have health benefits , particularly for older adults. There are also several studies that have concluded that the risk of type 2 diabetes is associated with a number of dimensions of social health including social isolation, loneliness, living arrangements, social support, and social network size.
However, the effects of each specific dimension of social health are complex, so a team of researchers from Luxembourg and Canada set out to investigate whether there was an association between marital status and marital quality with average glycemic levels in older adults.
They used biomarker data from the English Longitudinal Study of Aging (ELSA), a population-based sample of adults aged 50 and over and their partners, living in England, from whom data is collected every two years, with biomarker data collected in every other wave.
The data used for the study was from 3,335 adults aged 50 to 89 years without previously diagnosed diabetes during a period from 2004 to 2013.
The sample was people without pre-existing diabetes between the ages of 50 and 89 years at wave 2 (2004-05), when biomarker data first became available in ELSA. Pre-existing diabetes was determined by self-report.
Participants were invited to a nursing visit after the main interview in waves 2 (2004-05), 4 (2008-09), and 6 (2012-13) and blood samples were taken to measure their HbA1c (blood glucose). or average blood glucose) levels
Respondents were also asked whether they had a husband, wife, or partner with whom they lived and were asked questions designed to measure the level of social tension and social support within the marital/cohabiting relationship.
Information was also collected on several factors, such as details on age, income, employment, smoking, physical activity, depression, body mass index (BMI), and having other types of social relationships in their social network ( son, other immediate family member, friend).
The data showed that in wave 2 (2004-05), about three-quarters (76%) of respondents were married/cohabiting.
Analysis of the data over time showed that people who experienced marital transitions (e.g., divorce) also experienced significant changes in their HbA1c levels and odds of prediabetes.
However, relationship quality did not make a significant difference in average blood glucose levels, suggesting that having a supportive or strained relationship was less important than simply being in a relationship.
This was an observational study and as such cannot establish cause. In fact, the study had some limitations, such as the fact that there were a considerable number of people who dropped out of the ELSA between waves with biomarker data. More than half of the wave 2 sample had no follow-up data and were therefore excluded. There was also the possibility that those in poorer health were more likely to get divorced.
However, the authors argued that the strengths of their study included the use of HbA1c as an outcome measure versus self-reported diagnoses; the former is a more accurate measure when used in population surveys than diagnosed medical conditions which depend on participants having accessed appropriate medical care prior to study enrollment.
The researchers concluded: “Overall, our results suggested that marital/cohabitation relationships were inversely related to HbA1c levels, regardless of dimensions of marital support or strain. Likewise, these relationships seemed to have a protective effect against HbA1c levels above the prediabetes threshold.
“Increased support for older adults who are experiencing the loss of a marital or cohabiting relationship through divorce or bereavement, as well as dismantling negative stereotypes about romantic relationships in adulthood, can be starting points to address the health risks, more specifically the impairment of glycemic regulation associated with marital transitions in older adults.”
Conclusions
This study focused on the association of marital/cohabitation relationships with average glycemic level in older adults, following evidence suggesting that the types of relationships within one’s social network and the sources of social support and social strain are important for health outcomes. By focusing on this specific relationship type, we discovered its relevance to average glycemic levels of overall social support, strain, and network size.
Overall, our results suggested that marital/cohabiting relationships were inversely related to HbA1c levels, regardless of dimensions of marital strain or support. Likewise, these relationships seemed to have a protective effect against HbA1c levels above the prediabetes threshold. Increased support for older adults who are experiencing the loss of a marital/cohabiting relationship through divorce or bereavement, as well as dismantling negative stereotypes about romantic relationships in adulthood, may be starting points for addressing risks. for health, more specifically the deterioration of glycemic regulation, associated with marital transitions in older adults.
What is already known Social indicators of health, such as social network size, have diverse associations with the incidence and prevalence of type 2 diabetes. What does this study contribute? Cohabiting spouses/partners may be a particularly important type of relationship and a source of social support and/or stress for midlife adults, so we explored the specific benefits of this type of relationship among older adults. We found that having a spouse/partner was associated with lower average glycemic levels in people without preexisting diabetes, while indicators of marital quality (marital support/tension) generally did not appear to have significant associations with hemoglobin A1c (HbA1c) levels. How it affects clinical practice Clinicians may consider that older adults without preexisting diabetes who are experiencing marital/cohabitation partnership transitions may be at particular risk for worsening glycemic levels. |
